September 23, 2013

Two Italian MERS-CoV Cases Downgraded To Probable Cases

On Friday, September 20, 2013 the World Health Organization (WHO) downgraded two previously laboratory-confirmed cases of Middle East Respiratory Syndrome-Coronavirus (MERS-CoV) to probable cases.

The two cases are that of a 42-year-old woman and a two-year-old girl in Italy who were reported as confirmed cases on June 2, 2013 after a close relative who had recently returned home from the Middle East was confirmed the day before. The cases were among the few that had been confirmed outside the Middle East, with others coming from France, Germany, the UK and Tunisia, Africa.

The reclassification of the Italy cases follows further analysis of lab tests performed in May 2013, which now shows the two cases do not fulfill the current WHO definition for a “confirmed case” for MERS-CoV.

The “probable” designation refers to patients who are considered to have a high likelihood of having been infected with MERS-CoV, but from whom adequate samples could not be obtained for a complete test in accordance with the established criteria needed for laboratory confirmation.

The three cases from Italy were first confirmed in June by the country’s Ministry of Health, notifying the WHO via the European Union’s Early Warning Response System (EWRS). While the two latter cases have been relabeled as “probable” cases, the former is still a lab-confirmed positive for MERS-CoV.

With the newly released information, the global lab-confirmed case total drops from 132 cases to 130 cases. As of September 19, 2013, the death count still stands at 58.

The WHO continues to urge all Member States to monitor the situation closely and to report any signs of severe acute respiratory infections (SARI) and to carefully review unusual patterns. Any travelers who are returning from the Middle East and show any signs of respiratory distress or infection should visit a family doctor or hospital immediately.

The WHO does not advise special screening at points of entry with regard to this outbreak nor does it currently recommend the application of any travel or trade restrictions.

As for the Middle East, health experts in Saudi Arabia are also continuing to maintain high vigilance on the outbreak during the upcoming hajj season and an expected surge of millions of visitors to Mecca in October. The Ministry of Health has maintained that no suspected cases were evident during last year’s pilgrimage, which occurred shortly after MERS-CoV was first reported last September.

The Ministry of Health is still urging all elderly, children and those with compromised immunity or medical conditions to forgo this year’s pilgrimage to remove the risk of becoming infected.